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Post 01 Mar 2020, 4:29 pm

Well, it had to happen sometime I guess....we might have a crisis with the Clown in Charge. I feel so much better that the world-renowned infectious disease expert Mike Pence is on top of things.. One hopes that they are putting in plans on how to put in effective internal quarantines (how do you quarantine...Los Angeles?), have sufficient protective equipment on hand, how to treat thousands or tens of thousands of patients , and shifting medical personnel to hard-hit areas. Just saying that nothing is going to happen really is not effective planning. Hopefully, there is someone who knows what they are doing planning this out because this would be a massive logistical nightmare to deal with if it happens.
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Post 02 Mar 2020, 8:07 am

Folks are sure agitated. It spreads really easily, that's clear, but it doesn't seem to be very serious, as most people have mild or even no symptoms, though if you're very old or have a compromised immune system, it's very serious.

Question: is there much of a point trying to contain the virus? If it can be passed by people who have no symptoms, then how do you stop it?

Wouldn't it be better to focus on serious stuff that's happening right now, like this:
https://www.cdc.gov/drugresistance/biggest-threats.html

Where tens of thousands of people die every year (in the USA), and many more are permanently disfigured via amputations? Nationally we shrug our shoulders at the drug resistant bacteria, but the world is freaked out over this novel virus. One has happened gradually over time, the other is new. Does that have something to do with the agitation? Or do you think I misunderstand the threat?
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Post 02 Mar 2020, 1:33 pm

You're probably right for most healthy adults. From what I have read men are more vulnerable but that may be related to the fact that China has way more men who smoke than women (and thus may have underlying lung issues). And so far I have read it hasnt hit kids (but I dont think anyone has drawn any firm conclusions about that) In general, though, like the flu it is dangerous for the elderly, those with compromised immune systems. But with a 1% kill rate, highly contagious, and 300 million Americans...you do the math.
Last edited by freeman3 on 02 Mar 2020, 10:14 pm, edited 2 times in total.
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Post 02 Mar 2020, 4:06 pm

It could be huge, no doubt, as small percentages of big numbers are still big numbers.

But what can you really do about it if it can be transmitted around by people who don't know that they're sick? I don't know. It just seems like quarantines just delays the inevitable.
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Post 02 Mar 2020, 4:33 pm

China's draconian measures appear to be working Granted, they are a totalitarian state and can do some things that we would have difficulty doing. And we might be able to get a vaccine in a year or possibly an effective anti-viral treatment so delay could help.

https://www.sciencemag.org/news/2020/03 ... -countries
Last edited by freeman3 on 02 Mar 2020, 10:11 pm, edited 1 time in total.
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Post 02 Mar 2020, 9:49 pm

The latest estimate is a 1% fatality rate, ten times worse than the flu (but less than the 2 to 3% I originally put) Early figures indicate it is more contagious than seasonal flu.

https://www.google.com/amp/s/www.nytime ... u.amp.html
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Post 12 Mar 2020, 7:44 am

Epidemiology for Covid19 has shown the potential to infect 50 to 60% of the populace. (Germany says 60 to 70%)
300 million Americans x 50% = 150,000,000

Even if the fatality rate from infected people is only 0.7% (which is the rate currently in South Korea which leads the world in tests per million populace) that's over a million deaths in the US.

As virulent as Covid19 is ... only early and extreme measures are likely to slow down its spread. In the US where only 1700 people had been tested as of march 8 the likelihood is that CD19 is already spreading rapidly and well past the point of effective quarantine. Especially because the testing that is being done, isn't being well coordinated or properly tracked on a nation wide basis. And focuses for now on a small range of potential patients.
So now the focus should be on preparing for mass treatment.
Epidemiology in Korea has shown that about 10% of those infected may need to be hospitalized. And a large percentage of those will need ventilators.
There isn't a hospital system anywhere in the world that can cope with that kind of immediate need.Which threatens to increase the death rate. And will also affect health care for persons suffering from other problems as Corona overwhelms the system.
In China, they built a hospital in 7 days just to house Covid patients... Where else can this happen? What private business could accomplish this?

Early treatment is also helpful. If people are reluctant to go to a doctor or hospital because of cost (a uniquely American problem) .... that may increase the death rate among seriously affected patients. So you may find that South Korea's rate of 0.7% deaths from infections is not attained in the US and the number of deaths could be worse than 1,000,000.

https://www.businessinsider.com/coronav ... ind-2020-3
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Post 12 Mar 2020, 10:58 am

Perhaps this would be a good time to restrict travel into and out of each respective country. Enforcing border restrictions could be beneficial. Certainly if enforced prior to the outbreak, a reduced transmission vector would reap beneficial results. Another great reason to support intense border restrictions and screenings!

I am ALL for that.

That being said, I think a major over-reaction is occurring. Market drops, and cancellation of schooling, events, and conferences throughout the country is hyperbolic. Concerning Ricky's number of 1 million deaths in the US... Albeit a large number, I am confident that the medical system in the US will more than be capable of dealing with the threat of this virus.
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Post 12 Mar 2020, 12:01 pm

Virus is here since January and been spreading internally so travel bans are not as important right now. First, we need to focus on fixing the problem of a lack of testing ktis. That is priority number one. Secondly, we need hospitals to get ready for the influx of serious cases. I believe we have 70,000 ventilators in the US, hopefully that will be enough. Make more.I head heard 15-20% of people would get serious complications so if South Korea is getting only 10% hospitalization that's good. It may be that South Korea is just extremely efficient at everyone getting tested, even the very mild cases, and that is one cause for the discrepancy. Third, where is a cluster of cases we need to try and lockdown those areas if we can. Fourth, we need to put whatever resources would expedite getting a vaccine/anti-viral treatment as quickly as possible. Fifth, we need to think on how our economy can continue to function if this lasts more than a month or two. Sixth, Pence should not be directing this. You need someone with organizational/logistical ability running the response. Mitt Romney might be someone to think about (organized an Olympics)
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Post 13 Mar 2020, 7:54 am

bbauska
Albeit a large number, I am confident that the medical system in the US will more than be capable of dealing with the threat of this virus


Why? Does the experience of test kits give you that confidence?
The virus is already spreading through the community so at this point, quarantining is not going to stop the spread ...only slow it..

If 10 percent of the people who contract the virus end up needing hospitalization.... that will absolutely overwhelm hospitals. In Italy the hospitals in the zones that were hit badly did nothing but deal with Virus cases..... And they still had a high death rate because they had trouble coping.
If half of Americans eventually get the virus, and without a vaccine for more than a year, that's likely ... and 10% end up needing hospitalization that's 15 million people. There are only 900,000 hospital beds in the US. and only 75,000 ventilators. (The medical ventilator industry was forecasting an 8% growth rate world wide for their product just last month, driven largely by the increasing presence of cardiovascular diseases. So its doubtful they can quickly respond to this emergent demand).
https://www.marketresearchfuture.com/re ... market-695

People who are vulnerable to CD19 are those who are currently medically compromised, the obese, the elderly and smokers. If you are an obese old man who smokes ... you may have signed your death warrant.

The whole strategy with quarantining and social distance is to flatten the spread growth, so that medical facilities aren't overwhelmed, and can deal with the demand better. That is 50% get it, but over 4 to 6 months rather than over 1 month.
However, in Canada and the US, hospital bed occupancy is close to 100% now... In Canada, its easier to move out low priority patients and put them off.The system is managed by triage protocols that react And we had the experience of SARS which produced a response plan which has worked pretty well so far... (It included the completion of wings of positive air rooms (rooms where quarantined patients can be safely treated without virus spreading into the hospital air system.) . Apparently enough for now, but I'm pretty sure they will be overwhelmed eventually.

In the US, where medicine is a for profit industry, it may be more difficult to get hospitals to delay expensive and profitable surgeries to deal with patients who may not be able to pay ....
So I think, if things keep evolving as they have in South Korea, China and Italy .... there will shortly be a crisis because demand will greatly out strip available care...
You don't want to be in a car accident during the height of Coruna...

This isn't Ebola. Ebola was deadly but fairly hard to contract..And easy to identify carriers..\.. This is real easy to get, at this point hard to identify carriers, especially without adequate testing, but thankfully not dangerous to most who get the disease. Its insidious.
And not something our current medical system is adequate to deal with...
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Post 13 Mar 2020, 9:21 am

I would be surprised if we saw that number of deaths for a number of reasons. First, I think our health care system is better than China's health care system is. Secondly, if you look at China's death rate the death rate was by far the highest rate in Wuhan, as opposed to other areas which may have been due to early problems in diagnosing patients, they might have got better at treating patients as time got on, and they have might have been overwhelmed there. Also, Chinese smoke a lot more than we do and thus may be more susceptible. And we're getting hit later. And while the virus itself may turn out to be not affected by hotter weather, transmission of viruses is less in warmer weather (they don't go as far when coughed), people congregate less in warmer weather as they go outdoors more instead of being indoors close to other people and perhaps in poorly ventilated dwellings and human immune systems are likely better. If we can just flatten the curve by delaying transmission for a month or two, this thing might be mostly nipped in the bud.

No thanks to Trump who is a caricature of himself at this point and whose management has been monumentally stupid..but hopefully we will luck out. But there is no guarantee that what I indicated above will be accurate and yes experts are saying worst case scenario Ricky's figure could happen. I just think there are a number of reasons to think it wont be as bad as that.
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Post 13 Mar 2020, 9:46 am

I agree with Freeman on this, and was going to post the same points. In addition, I would add the the availability of medical care in the US compared to China.

I think this will subside, and make the same impact as MERS, SARS, Bird Flu, and Swine Flu.

Point of Statistic:22K-55K flu deaths this year so far... (IN THE US ALONE!)
Point of Statistic: 5,043 global fatalities due to Covid19

To compare Flu to Covid19 in the US - 37K Deaths for Flu (Averaged), and 41 for Covid19.

https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm
https://nypost.com/2020/03/13/global-coronavirus-death-toll-tops-5000/

Perhaps a bit of overreaction by some.

My point about containment and restriction of travel is prior to an outbreak, as it would limit transmission vectors incoming to the US. If we have less people coming, there is less opportunity for cross country transmission. Sounds simple enough to me.
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Post 13 Mar 2020, 12:21 pm

freeman3
First, I think our health care system is better than China's health care system is.


Is it? When it comes to corona? No has an anti viral that works, so treatment today consists of supporting the patient's breathing while their body fights the virus...
The only difference between the US and China? Maybe more ventilators in the US?More per capita?
However in China, they quarantined Wuhan and sent in 40,000 health care workers and built a a special facility to isolate and treat the most serious cases.They also sent in equipment from the rest of China, concentrating it in Wuhan...
You think the US can isolate the hot spots and send in reinforcements for health care from elsewhere? I seriously doubt it. Until yesterday the CDC couldn't even get reports on tests from all the States and independent labs.
And why is teh US response so disorganized?
The Trump Administration fired the Pandemic response team that Obama set up after the Ebola outbreak.
https://www.snopes.com/fact-check/trump ... emic-team/

Kind of reminds one of "Heckuva job Brownie", no?


freeman3
. Secondly, if you look at China's death rate the death rate was by far the highest rate in Wuhan, as opposed to other areas which may have been due to early problems in diagnosing patients

Yes. As the first place hit they were guessing. Then, it took a week from the point where China posted the genetic code of the virus to where WHO had a proposed test as a result of German and South Korean work. . The story of South Korea's battle to produce a test is well worth a read. They now produce a million tests a week .... puts the current US plight for test kits to shame.
China was hit harder because there wasn't testing available. The US is going to be hit hard for the same reason - despite the fact that the US had an 8 week warning..
https://www.cnn.com/2020/03/12/asia/cor ... index.html

freeman3

Also, Chinese smoke a lot more than we do and thus may be more susceptible. And we're getting hit later. And while the virus itself may turn out to be not affected by hotter weather, transmission of viruses is less in warmer weather (they don't go as far when coughed)

Old Chinese men are smokers. 60% smoke. So this is right.
But also vulnerable are the obese....and those already compromised medically. Especially those with cardio pulmonary problems and diabetes... There's a lot more obese diabetics per capita in the US than China.
As for warm weather? SIngapore has an out break and its always hot and humid there. Except maybe for December... A lot of travelers from Asia go through Singapore which is why it grew quickly there.. ... but if heat slowed it down it doesn't seem to have helped in Singapore.

freeman3
If we can just flatten the curve by delaying transmission for a month or two, this thing might be mostly nipped in the bud.


Hope so. At the least it will flatten demand and perhaps hospitals will be able to cope with demand. But until we get a vaccine and can develop herd immunity, I think people will continue to be infected. And no one knows about re-infection..... Which is scary.

On the plus side, maybe this will eventually and finally crush the anti vaccination movement.
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Post 13 Mar 2020, 12:50 pm

Point of Statistic:22K-55K flu deaths this year so far... (IN THE US ALONE!)

https://www.webmd.com/cold-and-flu/flu-statistics

So in a given year between 5% and 20% of Americans get the flu.

So flu has a mortality rate of 0.1%.
5% of Americans is 15 million. 0.1% of that is .. 15,000 people

20% of Americans is 60 million. 0,1% of that is 60,000 people

So far Covid 19 has a much higher mortality rate. Italy so far, has a mortality rate of 0.7%.Other areas have higher rates, but perhaps because the virus has spread further and without testing one can't tell what the actual infected base is... (Its much worse in Iran. Near 6%)

Covid 19 appears to be much more virulent than flu. Much easier to get. Which is why the expected infection rates are as high as 50% or more.... and of 50% infected, a death rate of 0.7% means 1,050,000.

The math is terrible Bbauska. And thats if hospitals are over loaded, and the 90,000 ventilators currently in use in American hospitals, are adequate...and they won't be if infection rates spike as in Italy .... then the death rate of 0.7% will probably be low. Without a known remedy, you can't cure covid19 only support the patient who's breathing is distressed... So lack of ventilators will be a crucial problem. Especially because of those 90,000 ventilators, how many are already in use? Half?
This is really scary...

bbauska
If we have less people coming, there is less opportunity for cross country transmission. Sounds simple enough to me.


Barn door after the cows have left... There's already domestic community transmission. And with inadequate testing the rate of spread is probably being well under reported.
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Post 13 Mar 2020, 3:45 pm

The flu transmits through droplets so weather impacts its spread. Covid 19 appears to transmit through surfaces. Warm weather won't necessarily give us a respite. Although Ricky's numbers are a bit exaggerated, I think he correctly provides a worse case scenario.

The U.S. is starting to self quarantine an amazing amount. Today and this weekend my son's school closed; his piano lesson was cancelled; no services tonight as our synagogue closed; his recreation basketball team closed; my bridge tournament was cancelled; my daughter's college closed; my company meeting was cancelled; my wife's job is suspended; I can't even watch the Celtics or the Bruins or the Revolution on TV. I've never seen anything like this ...